The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.
Pathogenesis of Obstructive and Central Sleep Apnea
Abstract
Considerable progress has been made over the last several decades in our understanding of the pathophysiology of both central and obstructive sleep apnea. Central sleep apnea, in its various forms, is generally the product of an unstable ventilatory control system (high loop gain) with increased controller gain (high hypercapnic responsiveness) generally being the cause. High plant gain can contribute under certain circumstances (hypercapnic patients). On the other hand, obstructive sleep apnea can develop as the result of a variety of physiologic characteristics. The combinations of these may vary considerably between patients. Most obstructive apnea patients have an anatomically small upper airway with augmented pharyngeal dilator muscle activation maintaining airway patency awake, but not asleep. However, individual variability in several phenotypic characteristics may ultimately determine who develops apnea and how severe the apnea will be. These include: (1) upper airway anatomy, (2) the ability of upper airway dilator muscles to respond to rising intrapharyngeal negative pressure and increasing Co(2) during sleep, (3) arousal threshold in response to respiratory stimulation, and (4) loop gain (ventilatory control instability). As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.
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Citations
Cites
Mezzanotte, W. S., Tangel, D. J., & White, D. P. (1992) · Journal of Clinical Investigation · doi:10.1172/jci115751 · Cited by 769
Self-citationA Mechanism of Central Sleep Apnea in Patients with Heart Failure
Javaheri, S. (1999) · New England Journal of Medicine · doi:10.1056/nejm199909233411304 · Cited by 498
Role of Arousals in the Pathogenesis of Obstructive Sleep Apnea
Younes, M. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200307-1023oc · Cited by 456 · cited 1×
“One would speculate therefore that an individual with a low arousal threshold would never reach stable sleep (77).”
BackgroundRespiratory Arousal From Sleep: Mechanisms and Significance
Berry, R. B., & Gleeson, K. (1997) · Sleep · doi:10.1093/sleep/20.8.654 · Cited by 308
Influence of sleep on tensor palatini EMG and upper airway resistance in normal men
Tangel, D. J., Mezzanotte, W. S., & White, D. P. (1991) · Journal of Applied Physiology · doi:10.1152/jappl.1991.70.6.2574 · Cited by 213
Self-citationGenioglossal But Not Palatal Muscle Activity Relates Closely to Pharyngeal Pressure
MALHOTRA, A., PILLAR, G., FOGEL, R. B., BEAUREGARD, J., EDWARDS, J. K., SLAMOWITZ, D. I., SHEA, S. A., & WHITE, D. P. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.162.3.9912067 · Cited by 148
Self-citationPharyngeal Pressure and Flow Effects on Genioglossus Activation in Normal Subjects
Malhotra, A., Pillar, G., Fogel, R. B., Edwards, J. K., Ayas, N., Akahoshi, T., Hess, D., & White, D. P. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.1.2011065 · Cited by 124
Self-citationInspiratory coactivation of the genioglossus enlarges retroglossal space in laryngectomized humans
Kobayashi, I., Perry, A., Rhymer, J., Wuyam, B., Hughes, P., Murphy, K., Innes, J. A., McIvor, J., Cheesman, A. D., & Guz, A. (1996) · Journal of Applied Physiology · doi:10.1152/jappl.1996.80.5.1595 · Cited by 85
Cited by
Control of sleep and wakefulness
Brown, R. E., Basheer, R., McKenna, J. T., Strecker, R. E., & McCarley, R. W. (2012) · Physiological Reviews · doi:10.1152/physrev.00032.2011 · Cited by 1,477
Goldberger, J. J., Cain, M. E., Hohnloser, S. H., Kadish, A. H., Knight, B. P., Lauer, M. S., Maron, B. J., Page, R. L., Passman, R. S., Siscovick, D., et al. (2008) · Circulation · doi:10.1161/circulationaha.107.189375 · Cited by 1,450
Obstructive sleep apnoea syndrome
Lévy, P., Kohler, M., McNicholas, W. T., Barbé, F., McEvoy, R. D., Somers, V. K., Lavie, L., & Pépin, J.-L. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.15 · Cited by 1,235
Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets
Eckert, D. J., White, D. P., Jordan, A. S., Malhotra, A., & Wellman, A. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201303-0448oc · Cited by 1,173
Self-citationPathophysiology of Adult Obstructive Sleep Apnea
Eckert, D. J., & Malhotra, A. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200707-114mg · Cited by 719
Eckert, D. J., Owens, R. L., Kehlmann, G. B., Wellman, A., Rahangdale, S., Yim-Yeh, S., White, D. P., & Malhotra, A. (2011) · Clinical Science · doi:10.1042/cs20100588 · Cited by 367
Self-citationInternational Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350
Edwards, B. A., Sands, S. A., Eckert, D. J., White, D. P., Butler, J. P., Owens, R. L., Malhotra, A., & Wellman, A. (2012) · The Journal of Physiology · doi:10.1113/jphysiol.2011.223925 · Cited by 298
Self-citationMarked reduction in obstructive sleep apnea severity in slow wave sleep
Ratnavadivel, R., Chau, N., Stadler, D., Yeo, A., McEvoy, R. D., & Catcheside, P. G. (2009) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27651 · Cited by 207
Itzhaki, S., Dorchin, H., Clark, G., Lavie, L., Lavie, P., & Pillar, G. (2007) · Chest · doi:10.1378/chest.06-0965 · Cited by 172
Trazodone Effects on Obstructive Sleep Apnea and Non-REM Arousal Threshold
Smales, E. T., Edwards, B. A., Deyoung, P. N., McSharry, D. G., Wellman, A., Velasquez, A., Owens, R., Orr, J. E., & Malhotra, A. (2015) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201408-399oc · Cited by 127
Edwards, B. A., Sands, S. A., Owens, R. L., Eckert, D. J., Landry, S., White, D. P., Malhotra, A., & Wellman, A. (2016) · Sleep · doi:10.5665/sleep.6226 · Cited by 125
Self-citationBiomechanics of the upper airway: Changing concepts in the pathogenesis of obstructive sleep apnea
Susarla, S. M., Thomas, R. J., Abramson, Z. R., & Kaban, L. B. (2010) · International Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.ijom.2010.09.007 · Cited by 99
Genioglossus premotoneurons and the negative pressure reflex in rats
Chamberlin, N. L., Eikermann, M., Fassbender, P., White, D. P., & Malhotra, A. (2007) · The Journal of Physiology · doi:10.1113/jphysiol.2006.121889 · Cited by 84
Self-citationSleep Apnea, Hypertension and the Sympathetic Nervous System in the Adult Population
Venkataraman, S., Vungarala, S., Covassin, N., & Somers, V. K. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9020591 · Cited by 84
“This excites the laryngeal mechanoceptors, which cause increased activity of the pharyngeal dilator muscles, thereby maintaining the airway [5,6].”
BackgroundLyons, O. D., Chan, C. T., Yadollahi, A., & Bradley, T. D. (2015) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201412-2288oc · Cited by 81
Sleep-Related Breathing Disorders in Patients With Tumors in the Head and Neck Region
Faiz, S. A., Balachandran, D., Hessel, A. C., Lei, X., Beadle, B. M., William, W. N., & Bashoura, L. (2014) · The Oncologist · doi:10.1634/theoncologist.2014-0176 · Cited by 68
Dellweg, D., Kerl, J., Hoehn, E., Wenzel, M., & Koehler, D. (2013) · Sleep · doi:10.5665/sleep.2878 · Cited by 64
Laryngopharyngeal reflux in obstructive sleep apnoea patients: Literature review and meta-analysis
Magliulo, G., Iannella, G., Polimeni, A., De Vincentiis, M., Meccariello, G., Gulotta, G., Pasquariello, B., Montevecchi, F., De Vito, A., D'Agostino, G., et al. (2018) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2018.09.006 · Cited by 54
Hypoglossal Nerve Stimulation and Airway Changes under Fluoroscopy
Goding, G. S., Tesfayesus, W., & Kezirian, E. J. (2012) · Otolaryngology–Head and Neck Surgery · doi:10.1177/0194599812436472 · Cited by 51
Subramanian, S., Hesselbacher, S., Mattewal, A., & Surani, S. (2013) · Sleep and Breathing · doi:10.1007/s11325-011-0644-4 · Cited by 41
Zhang, X.-B., Jiang, X.-T., Du, Y.-P., Yuan, Y.-T., & Chen, B. (2014) · PLoS ONE · doi:10.1371/journal.pone.0115033 · Cited by 26
Sleep Disorders in dogs: A Pathophysiological and Clinical Review
Mondino, A., Delucchi, L., Moeser, A., Cerdá-González, S., & Vanini, G. (2021) · Topics in Companion Animal Medicine · doi:10.1016/j.tcam.2021.100516 · Cited by 24
Balsamo, F., Berretta, E., Meneo, D., Baglioni, C., & Gelfo, F. (2024) · Brain Sciences · doi:10.3390/brainsci14070654 · Cited by 17
Metadata
- Authors
- White, D. P.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-12-01
- Volume
- 172
- Issue
- 11
- Pages
- 1363-1370
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2104274405
- Cited by
- 681
- References
- 8
- FWCI
- 14.23
- Type
- journal article
- Language
- en
- Open access
- closed
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